Gastric cancer treated by endoscopic submucosal dissection or endoscopic mucosal resection in Japan from 2004 through 2006: JGCA nationwide registry conducted in 2013
Gastric cancer treated by endoscopic submucosal dissection or endoscopic mucosal resection in Japan from 2004 through 2006: JGCA nationwide registry conducted in 2013
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DOI：
10.1007/s10120-017-0699-4
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发表时间：
2017-09-01
期刊：
影响因子：
7.4
通讯作者：
Katai, Hitoshi
中科院分区：
文献类型：
--
作者：
Tanabe, Satoshi;Hirabayashi, Shigeki;Katai, Hitoshi
日本胃癌协会（JGCA）于2008年启动了一项新的全国性胃癌登记研究，并报告了2001年和2003年接受手术治疗的原发性胃癌患者的治疗结果。然而，内镜治疗的结果还没有reported.Methods的JGCA在2013年进行了一项回顾性的全国性登记研究的短期和长期结果的内镜下粘膜切除术或内镜下粘膜剥离术治疗胃癌患者从2004年1月至2006年12月。该登记研究使用计算机化数据库，术语符合JGCA分类（第13版和第14版）和2010年日本胃癌治疗指南。结果从126家参与医院收集了12，647例患者的准确数据并进行了分析。81%的患者采用内镜粘膜下剥离术，19%采用内镜粘膜切除术。89%的患者实现了整块切除，79%的患者实现了R 0切除。接受根治性切除术的患者总比例为69.2%; 43.8%的患者对绝对适应症病变进行根治性切除术，25.4%的患者对扩大适应症病变进行根治性切除术。极少数患者（分别为0.3%和0.4%）进行了急诊手术治疗出血或穿孔。内镜切除术后5年随访率为70%。根治性切除术后绝对指征患者的5年总生存率为91.6%，扩大指征患者的5年总生存率为90.3%，非根治性切除患者的5年总生存率为86.5%。5年疾病特异性生存率分别为99.9%，99.7%和98.7%的绝对适应症的患者进行根治性切除，扩大适应症的患者进行根治性切除，和接受非根治性切除的患者分别。结论内镜下切除胃癌在日本全国范围内的良好的短期和长期的结果。需要进一步努力提高后续行动率。
Background The Japanese Gastric Cancer Association (JGCA) initiated a new nationwide gastric cancer registry in 2008 and reported the treatment outcomes of patients with primary gastric cancer who underwent surgical therapy in 2001 and 2003. However, the outcomes of endoscopic therapy have not been reported yet.Methods The JGCA conducted a retrospective nationwide registry in 2013 to investigate the short-term and long-term outcomes of endoscopic mucosal resection or endoscopic submucosal dissection in patients with gastric cancer treated from January 2004 through December 2006. This registry used a computerized database with terminology in accordance with the JGCA classification (13th and 14th editions) and the Japanese Gastric Cancer Treatment Guidelines from 2010.Results Accurate data on 12,647 patients were collected from 126 participating hospitals and analyzed. The treatment procedure was endoscopic submucosal dissection in 81% of the patients and endoscopic mucosal resection in 19%. En bloc and R0 resections were achieved in 89% and 79% of the patients respectively. The total proportion of patients who underwent curative resection was 69.2%; 43.8% of patients underwent curative resection for absolute indication lesions, and 25.4% underwent curative resection for expanded indication lesions. Emergency surgery was performed to treat bleeding or perforation in very few patients (0.3% and 0.4% respectively). The 5-year follow-up rate after endoscopic resection was 70%. The 5-year overall survival rate was 91.6% in patients with absolute indications and 90.3% in patients with expanded indications after curative resection and 86.5% in patients who underwent noncurative resection. The 5-year disease-specific survival rates were 99.9%, 99.7%, and 98.7% in patients with absolute indications who underwent curative resection, patients with expanded indications who underwent curative resection, and patients who underwent non-curative resection respectively.Conclusion Endoscopic resection of gastric cancer resulted in favorable short-term and long-term outcomes nationwide in Japan. Further efforts to increase the follow-up rate are needed.